Año 2021 / Volumen 113 / Número 9
Revisión
Timing of enteroscopy in overt-obscure gastrointestinal bleeding: a systematic review and meta-analysis

656-669

DOI: 10.17235/reed.2021.7976/2021

Catarina Gomes, Rolando Pinho, Ana Ponte, Maria Manuela Estevinho, João Carvalho,

Resumen
Background: the impact of early enteroscopy on the outcome of overt-obscure gastrointestinal bleeding (OGIB) is still unclear. Our aim was to evaluate the impact of early enteroscopy on overt-OGIB. Methods: the PubMed-MEDLINE, Web of Science, and Scopus databases were systematically reviewed. Observational retrospective studies comparing early versus non-early enteroscopy in overt-OGIB were identified. Data on diagnosis, treatment, and rebleeding were extracted from each study, and a meta-analysis was performed. Results: fifteen studies (comprising 1,907 patients) were included. Early enteroscopy was performed in 470 patients and non-early enteroscopy in 1,437 patients. Early enteroscopy was associated with a significantly higher diagnostic yield (odds ratio [OR] = 3.2, 95 % CI: 1.9-5.3; p = 0.002) and therapeutic yield (OR = 4.9, 95 % CI: 1.2-20.5; p = 0.03). However, moderate and high heterogeneity was observed in both analyses (DY I2 = 60.4 %; p = 0.002; TY I2 = 83.1 %; p < 0.001). When considering only studies where enteroscopy was performed during ongoing bleeding or within ≤ 24 h, ≤ 48 h, and ≤ 72 h of bleeding, heterogeneity was removed while the positive effect on diagnostic yield was maintained (OR = 4.7, 95 % CI: 3.4-6.6, p < 0.001, I2 = 0 %). Early enteroscopy did not significantly influence rebleeding rate (OR = 0.87, 95 % CI: 0.40-1.89, p = 0.72) in our analysis. Conclusions: in conclusion, early enteroscopy, especially when performed during ongoing bleeding or within 24 h, 48 h or 72 h of the bleeding episode, may increase diagnostic yield. Although an effect on therapeutic yield was observed, the value of early intervention has to be cautiously evaluated due to the high heterogeneity found among results. In our meta-analysis, early enteroscopy did not significantly influence rebleeding rate.
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25/10/2022 17:05:51
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Gomes C, Pinho R, Ponte A, Estevinho M, Carvalho J. Timing of enteroscopy in overt-obscure gastrointestinal bleeding: a systematic review and meta-analysis. 7976/2021


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Ficha Técnica

Recibido: 15/03/2021

Aceptado: 23/05/2021

Prepublicado: 01/06/2021

Publicado: 07/09/2021

Tiempo de revisión del artículo: 65 días

Tiempo de prepublicación: 78 días

Tiempo de edición del artículo: 176 días


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